DESCRIPTION: (Applicant's Abstract) Dr. Friedmann's goal is to gain the multidisciplinary tools required to become a leader in substance abuse health services research. Building on his strong training in primary care internal medicine and clinical epidemiology, Dr. Friedmann proposes to develop additional skills through: 1) interaction with a multidisciplinary sponsorship team; 2 tutorials and coursework designed to expand his theoretical and methodological horizons; and 3) a series of focused, supervised research projects. His research and career goals involve improving the quality and availability of primary health care for patients with substance use problems. The research proposed in this application examines the relationship between the outpatient drug treatment and primary care systems. This project represents the first step of Dr. Friedmann's research agenda in substance abuse health services research. He believes that the weak linkages between outpatient drug treatment, a specialty care system, and the primary care system result in inefficiencies and suboptimal health care and outcomes. The specific aims of this proposed research are: 1) to examine the delivery of medical and health promotion services within the system of outpatient drug treatment programs, including the organizational and environmental correlates of the provision of these services and the mechanisms used by outpatient drug treatment units to link their clients to these services; and 2) to examine the effect of different linkage arrangements on short and long-term patient-level health care utilization, and various health, drug use and social outcomes. During the final year of the award, Dr. Friedmann will seek external funding to examine the cost-effectiveness of these primary care linkage arrangements, as well as to define barriers to primary care access and the burden of preventable conditions in the drug treatment patient population. The University of Chicago has a long tradition of interdisciplinary research, as well as established research programs on drug abuse. As the PI of the Drug Abuse Treatment System Survey (NDATSS) funded by the NIDA, Thomas A. D'Aunno, Dr. Friedmann's mentor, is an established substance abuse health services researcher and organizational theorist. He will provide advanced training in organizational theory and survey research methodology. In addition, sponsors have been identified to provide further training in areas critical to Dr. Friedmann's development including clinical addictions and drug policy.